Sleep appliance

ABSTRACT

A dental oral appliance for use with patients who suffer with sleep disorders, to reduce or eliminate snoring and to open the airway for a sleeping individual who suffers with obstructive sleep apnea. The appliance covers the inside (lingual) of the upper teeth and has an open palate. Retention for the appliance is provided by either clasps placed over the upper right and left molars and a retainer in the anterior area or by an occlusal coverage of the upper teeth. A raised incisor ramp that extends from the incisal tip (biting edge) of the incisors toward the lingual, or posterior raised ramps, separate the posterior teeth to reduce spasm on the temporalis muscle. A transverse, transpalatal member, which extends from the inside (lingual) of the upper right molars to the inside of the upper left molars, covers the tongue, preventing it from moving upward or backward during sleep, opening the airway.

This application is a continuation of application Ser. No. 11/165,641,filed Jun. 23, 2005, which application is incorporated herein byreference in its entirety.

BACKGROUND OF THE INVENTION

The invention described in this application is an improvement over thedevice described in my U.S. Pat. No. 6,766,802, issued on Jul. 27, 2004.

As stated in my patent referenced above, it has been estimated thatninety million American adults and children snore and that one in everyten adults snores. Snoring can have serious medical consequences forsome people. Snoring is the first indication of a potentiallylife-threatening sleep disorder called Obstructive Sleep Apnea. If notdiagnosed or if left untreated, Obstructive Sleep Apnea could result insevere medical consequences such as systemic high blood pressure,cardiovascular disease and even sudden death.

Snoring is caused by vibration of the tissues due to air turbulence asthe airway narrows and may be a sign that a patient is suffering fromapnea. But not all snorers suffer from apnea. Snoring can be categorizedby its severity. There is the snorer who snores but experiences nophysical problems. Then there is the snorer who suffers from apnea, orthe snorer who suffers from upper airway resistance. In some of thesepeople, though they may not actually experience apneic episodes, theirsnoring is so loud and their breathing so labored, that it still wakesthem, and their partners, numerous times throughout the night.

Many spouses, partners and/or children suffer through the night from theannoying noise of the snorer. Snoring not only disturbs the sleepingpattern of the snorer himself, it is also disruptive to the family lifeby causing lack of sleep to all involved. This leaves all involvedunrefreshed, tired and sleepy throughout the day. It can causesleepiness while driving, reading, working or doing other tasks.

A broad variety of intra-oral and dental appliances and devices are nowavailable to treat a patient for snoring. Some known oral devices fortreating snoring and obstructive sleep apnea are worn inside of themouth and work by repositioning of the jaw, moving the mandible, liftingthe soft palate or moving the tongue forward. The various classes oftreatment devices that now exist include mandibular advancers and tongueadvancers. These appliances work by advancing the tongue and soft palateaway from the back wall of the throat. Other methods used to treatsnoring include controlled positive air flow pressure systems also knownas CPAP which require a nose mask and which are quite uncomfortable.

Other treatments for snoring include various surgeries, which aredrastic steps to take to attempt to cure the problem however snoring canbe so disruptive to a person's life and relationships, that somesufferers resort to surgery.

Another device which has been known is described in U.S. Pat. No.6,467,484 to De Voss. The device of De Voss fits entirely over the teethand presses against the inside of the mouth and the gums, making ituncomfortable for the user to wear. In addition, the device is held inthe users mouth only by pressure against the teeth from the groove inthe U-shaped member that fits over the teeth. If that pressure releasesfor any reason, such as material fatigue, the entire device can fall offof the teeth, which could be a very dangerous situation.

The devices described in my previously issued U.S. Pat. No. 6,766,802,issued on Jul. 27, 2004, were held in place by retainer wires andclasps. In addition, a transverse or transpalatal bar held the tonguedown to open the air space.

BRIEF DESCRIPTION OF THE INVENTION

The sleep appliance of this invention is a dental oral appliance for usewith patients who suffer with sleep disorders. Primarily it is designedto reduce or eliminate snoring and to open the airway for a sleepingindividual who suffers with obstructive sleep apnea.

One embodiment of the appliance is physically designed similar to anupper (maxillary) orthodontic retainer, commonly called a Hawleyretainer. It covers the inside (lingual) of the upper teeth and has anopen palate (nothing covering the middle area of the palate.) Retention(holding ability) for the appliance is provided by clasps. Anotherembodiment utilizes acrylic fittings which hold the appliance in placein the same manner as an occlusal night guard.

In the anterior area, there is a retainer wire or acrylic fittings tohold the anterior teeth in place or to move them backwards (inwardtowards the palate [linguallyj).

In one embodiment, in the anterior area over some or all of the upperincisors is a raised strip or ramp that extends from the incisal tip(biting edge) of the incisors toward the lingual. It extends backslightly from the middle of the central incisors (where they meet ortouch each other) up to the middle of the palate. This raised anteriorarea is to disclude or separate the posterior teeth. The net effect isto reduce spasm on the temporalis muscle and aid in reducing migraineand chronic tension headache pain that comes from bruxing and clenching(squeezing teeth together with potentially up to thousands of pounds ofpressure). Nocturnal bruxing and clenching are the cause of pain comingfrom the spasmed temporalis muscle.

In an additional embodiment there is no anterior ramp. The upper andlower teeth are separated by raised posterior ramps. This embodimentallows more room for the tongue to come forward, if desired.

There is a transverse strip, a substantially straight transpalatal bar,that extends from the inside (lingual) of the upper right molars to theinside of the upper left molars. This transverse strip extends from theright to the left and covers the tongue, preventing the tongue frommoving upward or backward during sleep.

To understand the effectiveness of the appliance, the mechanism ofsnoring and obstructive sleep apnea must be understood. While we sleep,the tongue falls back and up towards the palate and it partially orcompletely obstructs or closes the airway path. This results in snoring,obstructive sleep apnea, or Upper Airway Resistance Syndrome. Themedical treatment for these maladies range from medication to a CPAP(Continuous Positive Airway Pressure) machine. The CPAP is nearly 100%successful when utilized. Unfortunately, the non-compliance for CPAP useranges from 50% to 80% depending where one searches in the literature.The American Association of Sleep Medicine designated dental sleepappliances as the number one alternative to CPAP. The sleep appliance ofthis invention is designed to treat the problem of tongue blockage whensleeping. It works by utilizing several factors. First, it changes thevertical dimension (height of the opening or separation of the teeth).This results in an increased opening of the airway. Second, thetransverse strip that runs across the back of the appliance effectivelyholds the tongue down and prevents it from moving up or back and blockthe airway opening.

OBJECTS OF THE INVENTION

Accordingly, several objects and advantages of the invention are asfollows:

It is an object of this invention to provide a simple device to preventor reduce snoring as well as Obstructive Sleep Apnea.

It is another object of this invention to provide a device, easilyapplied and easily tolerated, which will substantially prevent snoring.

Further objects and advantages will become apparent from a considerationof the following description and drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a top view of the sleep appliance described in my earlierissued patent;

FIG. 2 is a bottom view or the device of this invention having posteriorprojections;

FIG. 3 is a bottom view with no wires being all acrylic;

FIG. 4 is a bottom view of, all acrylic, with projections;

FIG. 5 is a bottom view of an embodiment with an anterior raised acrylicramp;

FIG. 6 is a bottom view of the embodiment of FIG. 5 with projections onthe transpalatal bar;

FIG. 7 is a bottom view of the embodiment of FIG. 3 with a wider ramp;

FIG. 8 is a bottom view of the embodiment of FIG. 7 with projections onthe transpalatal bar;

FIG. 9 is a bottom view of the embodiment of FIG. 1 with no anteriorramp and raised posterior ramps;

FIG. 10 is a bottom view of the embodiment of FIG. 9 with projections onthe transpalatal bar;

FIG. 11 is a bottom view of an embodiment with no anterior ramp andraised posterior ramps;

FIG. 12 is a bottom view of the embodiment of FIG. 11 with projectionson the transpalatal bar;

FIG. 13 is a bottom view of an embodiment with an open transpalatal bar;and

FIG. 14 is bottom view of the embodiment of FIG. 13 with projections onthe transpalatal bar sections.

DETAILED DESCRIPTION OF THE INVENTION

Referring now to FIGS. 1 and 2, FIG. 1 shows the sleep appliancedescribed in my previously issued patent and FIG. 2 shows one embodimentof the sleep appliance of this invention. Shown in both FIGS. 1 and 2are appliance 10 having a body 12 which fits adjacent the inside of theupper teeth of the person wearing it. Body 12 fits snugly against thepalate, or roof of the mouth. Body 12 is generally U-shaped, however ithas a series of recesses 14, 16, 18 and 20, as well as additionalrecesses as needed, to fit the body 12 against the lingual side of theupper teeth, covering the inside of the upper teeth. The device iscustom fit to each patient by making a mold or dental impression of theinner surface of the upper teeth and the palate. The appliance is thenmade from the mold using a clear acrylic plastic commonly used fordental appliances.

Appliance 10 is held in place by an anterior retainer 22 and twoposterior retaining clasps 24 and 26. Anterior retainer 22 is a wire,usually made of metal and extends from eye-tooth to eye-tooth, #6-#11.Retainer wire 22 is similar to the standard wire used on orthodonticappliances to hold the anterior teeth in place or to move thembackwards, inward (lingually) towards the palate. These wires areusually made of stainless steel.

Appliance 10 is further held in place by two posterior retaining clasps24 and 26, commonly called Adams clasps, placed over upper right andleft molars, preferably the first molars. Clasps 24 and 26 are alsowires, usually made of metal, and usually stainless steel. Retainerwires 22, 24 and 26 hold appliance 10 securely in place.

Transverse strip or transpalatal bar 28 extends from the inside(lingual) of the upper right molars to the inside of the upper leftmolars, preferably the second molars.

Transpalatal bar 28 extends substantially straight from the right to theleft side of appliance 10, covering the tongue, with a gap between thetongue and transpalatal bar 28 and a gap between the palate andtranspalatal bar 28, acting as a tongue depressor, holding down thetongue, so that it cannot move upward or backward, leaving an open airpassage. As shown in FIG. 2, a plurality of posterior projections 32, 34and 36 have been added to the bottom 29 of transpalatal bar 28 tofurther hold the tongue down and thus further open the airway. Posteriorprojections 32, 34 and 36 may be from about 1 mm to about 6 mm longdepending upon the needs of the patient. While three projections areshown and they are cylindrical, any number, from about 2 to about 12projections may be used and they may be any shape, such as rectangular,conical, oval, or any other shape.

In the anterior area over the upper central incisors there is a raisedincisor strip or ramp 30 that extends from the incisal tip (biting edge)of two or more of the incisors toward the lingual. Strip 30 extends backfrom the middle of the central incisors, where they meet or touch eachother, to the middle of the palate. This raised strip 30 acts as a bitediscluder, separating the posterior teeth, which reduces spasm on thetemporalis muscle and aids in reducing migraine and chronic tension andheadache pain, which come from a spasmed temporalis muscle.

Strip 30 is preferably from about 3 mm to about 5 mm thick in order toseparate the posterior teeth. Body 12, tongue depressor 28, strip 30 andprojections 32, 34 and 36, are preferably made of a clear acrylicplastic commonly used for dental appliances, but could be made fromother plastics or rubber material.

In another embodiment shown in FIGS. 3 and 4, there is shown sleepappliance 40 which has no wire retainer or wire clasps. Body 42 is madeentirely of an acrylic plastic, commonly used for dental devices, and iscustom fitted to fit over the wearer's posterior teeth in the samemanner as an occlusal night guard which uses an occlusal coverage. Theocclusal coverage holds appliance 40 firmly onto the posterior teeth.

There is a raised anterior strip 44, similar to that shown in FIGS. 1and 2, to help separate the posterior teeth. A transpalatal bar 46 isattached to body 42 adjacent the molars to hold the tongue down and openthe airway. The embodiment of FIG. 4 has projections 48, 50 and 52, tohold the tongue down even further, if necessary to create a wider, moreopen airway.

Referring now to FIGS. 5 and 6 there is shown another embodiment of asleep appliance 54, having a body 56. Appliance 56 is held in place asshown in FIGS. 1 and 2, by anterior retainer 58 and two posteriorretaining clasps 60 and 62.

Raised anterior strip or ramp 64 is wider than the anterior ramp shownin FIGS. 1 and 2, as it includes and extends from all four maxillaryteeth. The beneficial effect of making anterior ramp 64 include all fourmaxillary teeth is that it distributes the load over four teeth insteadof just two teeth, reducing the load on each tooth.

Transpalatal bar 66 extends from the posterior molars on one side to theother, to hold the tongue down and increase the airway passage. In FIG.6, transpalatal bar 66 has a plurality of raised projections 68, 70 and72, which may be added to further hold the tongue down and increase theairway passage.

Referring to FIGS. 7 and 8, there is shown the sleep appliance shown inFIGS. 3 and 4, but with the wider anterior ramp as shown in FIGS. 5 and6. Sleep appliance 74 has body 76. There are no wires or clasps to holdappliance 74 in place. Body 76 is made entirely from an acrylic plasticand made to fit over the upper posterior teeth to hold it in place,similar to an occlusal night guard. Anterior ramp 78, as in FIGS. 5 and6, is wider than the ramp shown in FIGS. 1 and 2, extending across fourmaxillary teeth. Transpalatal bar 80, without projections in FIG. 7 andwith projections 82, 84 and 86 in FIG. 8, extends across from posteriormolars on one side to the other, to hold the tongue down and open theairway.

Referring to FIGS. 9 and 10 there is shown another embodiment of thesleep appliance 88 having body 90. Body 90, in this embodiment, has noanterior ramp. There are two raised posterior ramps 92 and 94 againstwhich the lower teeth occlude, to disclude the upper and lower teeth.The advantage of this embodiment is that the lack of the anterior rampallows the tongue to come farther forward, which opens the airway evenmore. Transpalatal bar 96 holds the tongue down to increase the airway.Transpalatal bar 96 has projections 98, 100 and 102, shown in FIG. 10.Appliance 88 is held in place, as shown in FIGS. 1 and 2, by anteriorretainer 104 and molar clasps, not seen, as they are hidden by posteriorramps 92 and 94.

Referring to FIGS. 11 and 12, sleep appliance 106 has body 108. There isno anterior ramp. Appliance 106 is all acrylic and fits as does anocclusal night guard, as described in FIGS. 3 and 4. Raised posteriorramps 110 and 112 provide a surface against which the lower teethocclude. Transpalatal bar 114 holds the tongue down to increase theairway. With no anterior ramp, the tongue can come forward increasingthe airway flow. Raised projections 116, 118 and 120 are shown in FIG.12.

Referring to FIGS. 13 and 14 there is sleep appliance 122 with body 14.Appliance 122 is held in place by anterior retainer 126 and molarclasps, as in FIGS. 1 and 2. These clasps are not shown as they arehidden under posterior ramps 128 and 130. In this embodiment, there isno anterior ramp. The transpalatal bar is split into and consists of twoportions 132 and 134 creating a space 136, from about ¼ to about ½ inchwide between the two portions 132 and 134 of the transpalatal bar. Theextra space 136 provides a further opening of the airway than when asolid transpalatal bar is used. The tongue is still held down butadditional space exists for the airway. Projections 138 and 140 arepresent, as shown in FIG. 14, on portions 132 and 134.

The split transpalatal bar may also be used on all of the acrylicappliances that have no wires, as shown in FIG. 3.

Having thus described the invention, it is requested that the inventionbe described by the scope of the following claims.

I claim:
 1. A dental oral appliance to open the airway for a sleepingindividual who suffers with at least one of snoring and obstructivesleep apnea, comprising: a body; structure configured to removably affixthe appliance to the upper teeth; structure configured to preventocclusion of the upper and lower teeth; and a transpalatal barconfigured to provide a gap between the transpalatal bar and the palate,and a gap between the transpalatal bar and the tongue, extending fromthe inside of one or more of the upper right molars to the inside of oneor more of the upper left molars, to restrain the tongue from upward andbackward movement.
 2. The dental oral appliance of claim 1 in which thestructure to removably affix the appliance to the upper teeth comprisesan occlusal coverage.
 3. The dental oral appliance of claim 1 in whichthe structure to prevent occlusion of the upper and lower teethcomprises a raised incisor ramp that extends from two or more incisorsto the lingual.
 4. The dental oral appliance of claim 1 in which thestructure to prevent occlusion of the upper and lower teeth comprisesraised posterior ramps.
 5. The dental oral appliance of claim 1 in whichthe body has a series of recesses which fit against the lingual side ofthe upper teeth.
 6. The dental oral appliance of claim 1 in which thebody is made of acrylic plastic.
 7. The dental oral appliance of claim 1in which the transpalatal bar is made of acrylic plastic.
 8. The dentaloral appliance of claim 1 in which the entire appliance is made ofacrylic plastic.
 9. The dental oral appliance of claim 1 in which thetranspalatal bar comprises two portions with a space between the twoportions.
 10. A dental oral appliance to open the airway for a sleepingindividual who suffers with snoring or obstructive sleep apneacomprising, a body having an open palate, an occlusal coverage toremovably affix the appliance to the upper teeth, structure configuredto prevent occlusion of the upper and lower teeth, a transpalatalmember, configured to provide a gap between the transpalatal member andthe palate, and a gap between the transpalatal member and the tongue,that extends from the inside of one or more of the upper right molars tothe inside of one or more of the upper left molars to inhibit thebackward and upward movement of the tongue during sleep.
 11. The dentaloral appliance of claim 10 in which the structure to prevent occlusionof the upper and lower teeth comprises a raised incisor strip thatextends from the incisal tip of two or more incisors to the lingual. 12.The dental oral appliance of claim 10 in which the structure to preventocclusion of the upper and lower teeth comprises raised posteriorocclusal ramps.
 13. The dental oral appliance of claim 10, in which thetranspalatal member comprises two portions with a space between the twoportions.
 14. The dental oral appliance of claim 10 in which thetranspalatal member is made of acrylic plastic.
 15. The dental oralappliance of claim 10 in which the entire appliance is made of acrylicplastic.
 16. A dental oral appliance to open the airway for a sleepingindividual who suffers with at least one of snoring and obstructivesleep apnea, comprising: a body; structure configured to removably affixthe appliance to the upper teeth; structure configured to preventocclusion of the upper and lower teeth; and a substantially straighttranspalatal bar configured to provide a gap between the transpalatalbar and the palate, and a gap between the transpalatal bar and thetongue, extending from the inside of one or more of the upper rightmolars to the inside of one or more of the upper left molars, torestrain the tongue from upward and backward movement.
 17. The dentaloral appliance of claim 16 in which the structure to prevent occlusionof the upper and lower teeth comprises a raised incisor strip thatextends from the incisal tip of two or more incisors to the lingual. 18.The dental oral appliance of claim 16 in which the structure to preventocclusion of the upper and lower teeth comprises raised posteriorocclusal ramps.
 19. The dental oral appliance of claim 16 in which thetranspalatal member comprises two portions with a space between the twoportions.
 20. The dental oral appliance of claim 16 in which the entireappliance is made of acrylic plastic.